Individual provider Active NPI

Anita Ky Ngo, PHARM D

  • Pharmacist
  • Golden Valley, MN
National Provider Identifier
1639527617
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
122004 Issued in MN
Practice address
8441 Wayzata Blvd Ste 340
Golden Valley, MN 55426-1372
Phone
(952) 542-5515
NPI assigned
May 31, 2016
Last updated
May 31, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 122004 MN Primary

Addresses

Primary practice location

8441 Wayzata Blvd Ste 340
Golden Valley, MN 55426-1372

Mailing address

3433 Lake Johanna Blvd
Arden Hills, MN 55112-7935

Other names 1

  • Anita Ky Ngo-Peterson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
122004MNMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1639527617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 LAKE JOHANNA BLVD",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "551127935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8441 WAYZATA BLVD STE 340",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261372",
            "telephone_number": "952-542-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "ANITA",
        "middle_name": "KY",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "122004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANITA",
            "last_name": "NGO-PETERSON",
            "middle_name": "KY",
            "credential": "PHARM D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.